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Pelvic Organ Prolapse: Treatment Options

The goal of continence surgery or pelvic reconstructive surgery is to recreate normal anatomy. None of these procedures, however, has a 100 percent success rate.

In many cases, only a partial failure occurs, requiring pessary use, surgery that is less extensive than the original surgery, or no treatment at all. Patients who follow our recommended restrictions for 12 weeks after surgery give themselves the best chance for permanent success.

Techniques

Pessary

A pessary is a supportive device that is placed in the vagina to elevate it. Positioned similarly to a contraceptive diaphragm, the pessary uses the strength of the pelvic bones to support the vagina. Pessaries come in a variety of shapes and sizes and are most commonly made from either silicone or latex. Patients may continuously wear their pessary but should remove and clean it on a regular basis. Pessaries may be used as a temporary aid prior to surgery or as a permanent treatment for prolapse.

Surgery

Techniques that use permanent sutures to attach the vagina to the pelvic bones rely on the strength of these bones to support the vagina. The surgery may involve a vaginal or abdominal incision, or both. Determining the precise urinary problem prior to surgery ensures selection of the best technique.

After-Surgery Care

You will be in the hospital for one to four days, depending on the extent of your surgery. Most patients require at least some prescription-strength pain medicine for one or two weeks after surgery.

You should avoid strenuous physical activity, especially lifting heavy objects, for 12 weeks to allow proper healing. Increased physical straining adds to the force against these weak pelvic muscles, possibly resulting in worsening prolapse or damage to a surgical repair.